This study proposes to evaluate in the academic environment and in the community the relative efficacy of cytologic and microhistologic technics for the detection of endometrial cancer and its precursors. Three technics, namely the endometrial aspiration (Vakutage), the endocervical aspiration and the routine vaginal, ectocervical and endocervical (VCE) cytologic smears, will be assessed. The present application is a continuation of an ongoing project at The University of Chicago which requires further studies in three main aspects: testing of the three technics on a large and statistically valid number of patients; assessment of the performance level of the three technics in a community setting (Outreach Program); and determination of the optimal fixation technic for endometrial samples which have to be transported for processing to a central laboratory. At The University of Chicago we will continue with sample collections from outpatients who belong to the high risk group for endometrial cancer and its precursors. To test the performance level of the three technics in the community, two phases will be required: In a preparatory stage we will teach clinicians how to obtain good samples and provide guidelines to obtain the best results possible. In the main stage of the study we will assess detection rates of endometrial cancer and its precursors on 400 patients employing a combination of the three technics. The optimal fixation technic for the endometrial aspirate will be investigated in the preparatory stage of the Outreach Program, utilizing various fixatives. The diagnostic accuracy of the methods of collection is to be assessed in an academic setting as well as in the community practice, and the hypothesis will be tested as to whether significant differences exist between the three methods and whether a combination of methods provides significantly better accuracy than any single method.